{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T18:16:57Z","timestamp":1776795417556,"version":"3.51.2"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2026,4,5]]},"abstract":"<jats:p>Abdominal epilepsy is rare but under-recognised, characterised by paroxysmal abdominal symptoms with no identifiable gastrointestinal cause. A 77-year-old woman had a lifelong history of brief nocturnal episodes of abdominal cramping followed by transient confusion and speech difficulty. An MR scan of brain within 24 hours of an event identified cortical diffusion restriction and increased FLAIR signal in the left frontal operculum and insular cortex, consistent with peri-ictal MRI abnormalities. Electroencephalography was normal. Her symptoms completely resolved after starting antiseizure medication. This case highlights the importance of considering neurological causes in unexplained recurrent abdominal pain and expands the phenotypic and radiological spectrum of abdominal epilepsy. The involvement of the insular cortex, a central hub for autonomic and viscerosensory processing, provides imaging-based evidence supporting its role as a key anatomical substrate in abdominal epilepsy.<\/jats:p>","DOI":"10.1136\/pn-2026-005146","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T17:20:34Z","timestamp":1776792034000},"page":"pn-2026-005146","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Abdominal epilepsy with peri-ictal MRI abnormality"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7498-7751","authenticated-orcid":false,"given":"Julia Fernandes Alves","family":"De Oliveira","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Neurologia, Universidade Federal do Rio de Janeiro (UFRJ) Hospital Universit\u00e1rio Clementino Fraga Filho, Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline Stephanie Fernandes","family":"Do Nascimento","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neurologia, Universidade Federal do Rio de Janeiro (UFRJ) Hospital Universit\u00e1rio Clementino Fraga Filho, Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2417-0406","authenticated-orcid":false,"given":"Helena","family":"Bethlem Mirow","sequence":"additional","affiliation":[{"name":"Disciplina de Neurologia, Cl\u00ednica M\u00e9dica 3, Universidade Estacio de S\u00e1 (IDOMED), Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4578-369X","authenticated-orcid":false,"given":"Mariana Ribeiro","family":"Pereira","sequence":"additional","affiliation":[{"name":"Neurogen\u00e9tica, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, Ribeirao Preto, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7147-6418","authenticated-orcid":false,"given":"Victor","family":"Evangelista Rodrigues Pereira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neurologia, Universidade Federal do Rio de Janeiro (UFRJ) Hospital Universit\u00e1rio Clementino Fraga Filho, Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"2026042110202141000_pn-2026-005146v1.1","first-page":"347","article-title":"Abdominal Epilepsy","volume":"40","year":"1886","journal-title":"Hospital (Lond, 1886)"},{"key":"2026042110202141000_pn-2026-005146v1.2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.094250"},{"key":"2026042110202141000_pn-2026-005146v1.3","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.seizure.2017.06.024","article-title":"The spectrum of peri-ictal MRI changes; four illustrative cases","volume":"50","author":"Williams","year":"2017","journal-title":"Seizure"},{"key":"2026042110202141000_pn-2026-005146v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2017.02.013"},{"key":"2026042110202141000_pn-2026-005146v1.5","doi-asserted-by":"crossref","DOI":"10.3390\/brainsci11111533","article-title":"The Insula: A Stimulating Island of the Brain","volume":"11","author":"Rachidi","year":"2021","journal-title":"Brain Sci"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2026-005146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T17:20:35Z","timestamp":1776792035000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2026-005146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":5,"alternative-id":["10.1136\/pn-2026-005146"],"URL":"https:\/\/doi.org\/10.1136\/pn-2026-005146","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]}}}